New Study Reveals Quitting Smoking is Good but Switching to Low-risk Nicotine Products is Usually Better

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Prof. Carl V. Phillips, just published in Harm Reduction Journal, shows that for most smokers, immediately switching to a low-risk alternative will lower their risk of dying from their habit more than quitting eventually, even if they use the smoke-free product for the rest of their lives.

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Switching to low-risk nicotine products, like smokeless tobacco, electronic cigarettes, and pharmaceutical nicotine, offers smokers a chance to almost completely eliminate their health risks. While these alternative products still pose some very small health risk, a new study at the University of Alberta School of Public Health in Canada shows that in most cases switching is better for reducing lifetime risk than trying to quit. The study by Prof. Carl V. Phillips, just published in Harm Reduction Journal, shows that for most smokers, immediately switching to a low-risk alternative will lower their risk of dying from their habit more than quitting eventually, even if they use the smoke-free product for the rest of their lives.

For the average smoker, the study finds, smoking for just one more month poses a greater health risk than a lifetime of using one of the increasingly popular low risk products like snuff, snus, the new electronic imitation cigarettes, nicotine lozenges, or some other non-combustion alternative. Switching products is a strategy known as "tobacco harm reduction." "It has long been known that while no nicotine product is completely harmless, harm reduction products pose only about 1% the risk from smoking," says Dr. Phillips, "and this difference is so great that for the average smoker, using a smokeless product for the rest of his life poses about the same risk as 30 days of continuing to smoke." What this means is that most smokers, even those who plan to quit soon, will not quit before damaging their health far more than using low-risk products for a lifetime. Moreover, for some older smokers, smoking for a day or two more poses a greater risk than using a low-risk product for the rest of their life. Since switching products is often much more appealing to smokers than quitting nicotine entirely, this option is more practical than quitting and leaves the former smoker happier and less likely to relapse. Those who switch can still choose to quit entirely later, lowering their risk further still.

Dr. Phillips and his public health research group publish the website http://www.TobaccoHarmReduction.org, and have worked for years to educate smokers about the advantages of low-risk alternatives. The new study, which also looks at some of the history and politics of tobacco harm reduction, suggests that efforts to promote abstinence as the only healthy choice may be killing thousands of smokers per month. Discouraging switching causes the deaths of far more smokers than could ever die from using low-risk nicotine products for their entire lives.

This study comes on the heels of a major study by Peter Lee, published in another BioMed Central journal, BMC Medicine, that showed that the cancer risk from smokeless tobacco is so small it cannot even be reliably measured. Given the ample evidence about the risks of different products, "there is no scientific basis for denying the benefits of tobacco harm reduction" says Phillips, "and it is time that we offer smokers honest public health interventions rather than the moralizing and deadly 'abstinence-only' approach." The abstinence-only approach leaves many ex-smokers miserable and leaves millions of others no choice but to keep smoking. Some activists object to alternative products because they let smokers stay addicted to nicotine or allow companies to profit from selling the products. But, asks Phillips, "is addiction to a low-risk habit -- not much different from drinking coffee -- really such a problem, or is the profitability of some companies so terrible that it outweighs the millions of lives that could be saved by harm reduction?"

Professor Phillips is an epidemiologist and health policy researcher, journal editor, popular educator, and consultant. He and his work group are leading advocates of tobacco harm reduction, and he advises and works with many other organizations who are trying to promote it, some of which are companies that hope to profit from selling low-risk nicotine products. The http://www.TobaccoHarmReduction.org research group at the University of Alberta School of Public Health is partially supported by an unrestricted (completely hands-off) grant from U.S. Smokeless Tobacco Company. No funder, company, or other organization played any role in initiating, designing, or conducting this research.